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Nonprofiteer
← BAYCARE SELECT HEALTH PLANS INC

Form 990 for tax year 2023

Filed by BAYCARE SELECT HEALTH PLANS INC.

Totals

Total revenue
$151,635,595
Total expenses
$176,638,684
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$159,688,311
Management and general expenses
$16,950,373
Fundraising expenses
$0
Program service expenses (Part III)
$159,688,311

Program services were 90.4% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ROBERT MCGIVNEY

    TRUSTEE/SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • VICTOR KRAUZE

    TRUSTEE/CHAIRMAN

    Total calculated
    $0
    Hours/week
    1

  • ANDY BURWELL

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • DAVID HILLS

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • RAVI CHARI

    TRUSTEE (until May 2023)

    Total calculated
    $0
    Hours/week
    1

  • STEPHANIE CONNERS

    TRUSTEE/PRESIDENT & CEO BAYCARE

    Total calculated
    $2,709,242
    From this org
    $0
    From related orgs
    $2,576,114
    Other
    $133,128
    Hours/week
    1 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,576,101 related
    Bonus
    $0 + $725,000 related
    Other
    $0 + $275,013 related
    Deferred
    $0 + $115,982 related
    Nontaxable benefits
    $0 + $17,146 related
    Filer's total
    $0 + $2,709,242 related

  • THOMAS CARDY

    TRUSTEE (until Nov 2023)

    Total calculated
    $0
    Hours/week
    1

  • JANICE POLO

    TREASURER/EVP, CFO BAYCARE

    Total calculated
    $2,040,740
    From this org
    $0
    From related orgs
    $1,971,629
    Other
    $69,111
    Hours/week
    1 + 46 related

    Schedule J breakdown matched by us

    Base
    $0 + $978,748 related
    Bonus
    $0 + $504,176 related
    Other
    $0 + $488,706 related
    Deferred
    $0 + $22,387 related
    Nontaxable benefits
    $0 + $46,723 related
    Filer's total
    $0 + $2,040,740 related

  • MELISA SHAWN ARMSTRONG

    PRESIDENT/VP BayCare Health Plans (eff June 2023)

    Total calculated
    $328,826
    From this org
    $0
    From related orgs
    $290,384
    Other
    $38,442
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $215,543 related
    Bonus
    $0 + $669 related
    Other
    $0 + $74,172 related
    Deferred
    $0 + $7,274 related
    Nontaxable benefits
    $0 + $31,168 related
    Filer's total
    $0 + $328,826 related

  • NANCY HORSTMANN

    PRESIDENT (until June 2023)

    Total calculated
    $761,578
    From this org
    $761,578
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $761,578
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $761,578

  • JACQUELYN CAWLEY

    Former VP & CMO

    Total calculated
    $1,261,239
    From this org
    $0
    From related orgs
    $1,152,866
    Other
    $108,373
    Hours/week
    0 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $438,888 related
    Bonus
    $0 + $164,254 related
    Other
    $0 + $549,724 related
    Deferred
    $0 + $71,943 related
    Nontaxable benefits
    $0 + $36,430 related
    Filer's total
    $0 + $1,261,238 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
The filing organization does not use any of the options listed in Schedule J, Part I, Line 3 to establish the compensation of the CEO/Executive Director. However, the related organization, BayCare Health System Inc, uses Compensation committee, Independent compensation consultant, Written employment contract, Compensation survey or study and Approval by the board or compensation committee as a means to establish compensation of the top management official of the filing organization.
Schedule J, Part I, Line 4a Severance or change-of-control payment
Jacquelyn Cawley received a severance payment in the amount of $477,589 during 2023.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
BayCare Health System provides two nonqualified deferred compensation plans to executive level employees: Executive Nonqualified Defined Contribution Plan The plan provides for annual credits of a specified percentage of an eligible participant's eligible compensation paid in a plan year and interest credits. Plan participants vest in increasing percentages based on years of service. Further, a participant shall become fully vested upon the participant's death, total and permanent disability or due to involuntary separation of employment other than for cause, or upon reaching retirement age. Payments made during employment are made for required tax withholding and reduce the participant's account balance. Distribution of the vested account balance occurs upon termination of employment. The plan is frozen for the participants hired after 1.1.2018. Supplemental Executive Retirement Plan The plan provides for annual credits to the participant's company contribution account of a specified percentage of an eligible participant's eligible compensation paid in a plan year and investment income credits. Plan participants vest on January 1 of the fifth Plan Year following the Plan Year for which the contribution was made. Further, a participant shall become fully vested upon the participant's death, total and permanent disability or due to involuntary separation of employment other than for cause, or upon reaching retirement age. Distribution of the vested amounts shall be made no later than the earlier of 90 days following the date the amounts become vested or the March 15th following the Plan Year in which the participant became vested. Amounts accrued, vested and distributed for plan participants are provided below. Stephanie Conners - Participated in a supplemental nonqualified deferred compensation plan. She had $105,513 of nonvested benefits accrue in 2023. This amount is included in Part II (C) Retirement and other deferred compensation. Janice Polo - Participated in a supplemental nonqualified deferred compensation plan. She had $312,946 in benefits vest in 2023. This amount is included in Part II (B)(iii) Other compensation. The plan made cash distribution of $123,144 in 2023. Jacquelyn Cawley - Participated in a supplemental nonqualified deferred compensation plan. She had $62,043 of nonvested benefits accrue during 2023. This amount is included in Part II (C) Retirement and other deferred compensation.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2023
Filed
12 November 2024
IRS schema version
2023v5.1
Source object
202443179349305804

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